A prospective comparative study between conservative and operative treatment with dynamic hip screw in the management of intertrochanteric fracture of the femur

Abstract

Introduction: Trochanteric fracture of femur is extremely common in elderly age group. Nowadays, most of these fractures will be surgically fixed with implants. However, some patients can be treated with conservative treatment but internal fixation with Dynamic hip screw is most acceptable method and has better outcome. The aim of present study is to compare the result of conservative method and operative treatment with dynamic hip screw in management of intertrochanteric fracture of the femur in rural population where modern surgical facilities are unavailable.Material and Method: In our study sixty patients were selected for the study out of which 40 patients were treated with operative method with dynamic hip screw (DHS) and twenty patient were treated with conservative method. The conservative group and the operative group are classified as Group I and Group II respectively. The result were evaluated and graded as excellent, good and poor as per Kyle’s criteria.Result: In the present study in Group I, 20% had union in 8 weeks, 60% in 10 – 12 weeks and 20% in more than 12 weeks. In Group II, 50% had union in 6 weeks, 40% in 6-8 weeks and 10% in more than 8 weeks. In group one 4 (20%) patients has excellent result, 4 (20%) patients had good result and 12 (60%) patients had poor result whereas in Group II 32 (80%) patients had excellent result, 6 (15%) patients had good and 2 (5%) patients had poor result. In Group I, 4 (20%) patients had no complications while 16 (80%) patients had one or more complications whereas in Group II 32 (80%) patients had no complications and 8 (20%) patients had one or more complications.Conclusion: The overall quality of result was better with internal fixation with dynamic hip screw (DHS) as compared to conservative method, avoiding all the problems of prolonged recumbency and tended to leave the hospital sooner. However, conservative treatment will be acceptable where modern surgical facilities are unavailable.